How I Do It: Contrast-enhanced US Applications in Children.

Contrast-enhanced US (CEUS) allows a detailed assessment of the tissue microvasculature after intravenous injection of contrast material. The use of CEUS also allows opacification of nonvascular hollow organs and fluid compartments after intracavitary instillation of dilute contrast material. This capability is far beyond that of grayscale and Doppler US techniques. The advantages of CEUS include its ease of use, high safety profile, and absence of ionizing radiation, making it an ideal tool for pediatric imaging. In 2016, the U.S. Food and Drug Administration approved CEUS for use in children for characterization of focal liver lesions and diagnosis of vesicoureteral reflux. Because the US contrast agent is distributed throughout the vascular pool, additional off-label imaging studies have focused on a variety of anatomic structures. This review of pediatric CEUS discusses the safety and technical aspects of CEUS, provides practical information on how to perform intravascular and intracavitary examinations, addresses the most common clinical applications of this method, and offers advice regarding the integration of CEUS into pediatric daily clinical practice.